Carbuncle - the swollen painful nape
Carbuncle is a spreading infection below the skin which causes the tissues to die (necrosis). The characteristics of it is that there are many openings which have pus or blood discharging from its centre. The centre may be soft but otherwise the surrounding tissue is firm and inflammed and the skin becomes warm and red. The condition commonly occurs among those with diabetes mellitus and the treatment is surgical with antibiotics administration.
The comonest surgical procedure is called saucerization in which the whole infected and dead tissue is excised leaving a large clean cavity which would require daily dressing for the wound to heal on its own.
Below is a young diabetic lady who had many similar episode and never learns that her diabetes and her sugar control is of utmost importance.
This is an elderly lady with diabetes who kept the infection for about 2 weeks and presented ill with sepsis.
This is another elderly lady who did not have diabetes but had a huge colllection of pus after a wound infection which she kept for so long that it extended down to her labia.
October 31st, 2006 at 1:31 am
oh…. will have to take care of sugar levels
October 31st, 2006 at 2:36 am
The lady with multiple carbuncle : did you check her cultures. We must exclude Melioidosis. Next time probably we should ask the microbiologist to look for B.pseudomallei carefully.
Pagal
October 31st, 2006 at 3:15 am
Hi Pagal, nice to hear from you again. How’s life in JB (i presume?) Thanks for the tip. I’ll remember that. Especially since we do get more patients from an agricultural background than KL-ites.
October 31st, 2006 at 12:39 pm
haihss..why pts tend to wait so long b4 they seek medical treatment ar?…
October 31st, 2006 at 2:51 pm
Ooh! Thanks for visiting Paga. I will have to agree with you. I actually had a case about a month ago when an elderly lady was admitted with fever chills and multiple areas of abscess over the scalp body and legs and was diabetic. Her cultures were positive for meliodosis. But the above lady had carbuncle / abscesses at different periods of time, so still possible?
eve ya lo always lke that one. Actually, very normal human reaction, fear of the unknown. that is why the fear factor can be so good show. Dont you think?
November 1st, 2006 at 4:18 am
Yes george, it is still possible for patients to come with recurrent multiple abscesses at different time period. If Melioidosis is not picked up that one find day they will present with fatal sepsis and pneumonia.
November 1st, 2006 at 4:40 pm
Ye ke? okay ! did you see an article in the MMJ about meliodosis?